While the spread of COVID-19 may finally be slowing, government enforcement of pandemic-related fraud is not. It is surging. And that may explain why you are hearing from the government more than usual, or will soon. The U.S. Department of Justice (DOJ) announced last week that it has now charged nearly 500 defendants with crimes… Continue Reading
Last month, the Eleventh Circuit upheld the conviction and 11-year prison sentence of a physician-Medical Director of two substance abuse treatment centers in Florida who was convicted by a jury of participating in a conspiracy to commit healthcare fraud. On appeal, Arman Abovyan, a board-certified internal medicine physician, challenged his convictions based on insufficiency of… Continue Reading
As previously discussed, on April 3, 2020, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a process for inquiries to be submitted to OIG about whether administrative enforcement discretion would be provided for certain arrangements directly connected to the 2019 novel coronavirus (COVID-19). OIG established this process to provide regulatory… Continue Reading
The U.S. Fifth Circuit recently reversed a former home health agency employee’s conviction and vacated his sentence related to three counts of healthcare fraud and abuse. Jonathan Nora was convicted by the trial court of conspiracy to commit health care fraud, aiding and abetting healthcare fraud, and several violations of the Federal Anti-Kickback Statute (AKS)… Continue Reading
On March 11, 2021, President Joe Biden signed into law H.R. 1319, the American Rescue Plan Act of 2021. The American Rescue Plan’s $1.9 trillion in spending, contains numerous provisions impacting healthcare, including medical insurance, services delivery and providers. The American Rescue Plan also provides $5 million to the HHS Office of Inspector General (OIG)… Continue Reading
As mentioned in our previous article, last month we were pleased to welcome former DOJ prosecutor Michael Podberesky to McGuireWoods. The below is the continuation of our Q&A with Michael: Brett: What is some advice that you would provide to a client that is responding to a Civil Investigative Demand (CID) or subpoena? Michael: READ… Continue Reading
The U.S. Supreme Court recently declined to address a circuit split regarding the standard for establishing that a statement material to a claim for payment is false under the False Claims Act (FCA); specifically, whether the FCA requires pleading and proof of an “objectively false statement,” or whether liability can be based on allegedly false… Continue Reading
Last month we were pleased to welcome former DOJ prosecutor Michael Podberesky to McGuireWoods. Michael comes to McGuireWoods after a five and a half year stint as a fraud prosecutor focused mainly on healthcare enforcement under the guise of the False Claims Act. Below is a short Q&A with Michael discussing his background and recent… Continue Reading
The United States Department of Justice (DOJ) recently announced the nation’s largest settlement involving allegations of drug diversion at a health care system. The settlement, totaling $7,750,000, came after a years-long investigation by the U.S. Drug Enforcement Administration (DEA) into McLaren Health Care Corporation (MHCC). The DEA concluded that MHCC’s handling of controlled substances violated… Continue Reading
As previously discussed, on April 3, 2020, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a process for inquiries to be submitted to OIG about whether administrative enforcement discretion would be provided for certain arrangements directly connected to the 2019 novel coronavirus (COVID-19). OIG established this process to provide regulatory… Continue Reading
In a recent opinion from the U.S. District Court for the District of Minnesota, the court analyzed the interplay between the False Claims Act and the Anti-Kickback Statute. See United States ex rel. Fesenmaier v. Cameron-Ehlen Group, Inc., Case No. 13-cv-3003, 2021 WL 101193 (D. Minn. Jan. 12, 2021). This opinion is significant because the… Continue Reading
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